1. Determination of hepatitis B phenotype using biochemical and serological markers
- Author
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Di Bisceglie, AM, Lombardero, M, Teckman, J, Roberts, L, Janssen, HLA, Belle, SH, Hoofnagle, JH, Hbrn, and Gastroenterology & Hepatology
- Subjects
Adult ,Male ,0301 basic medicine ,Adolescent ,Article ,Serology ,Cohort Studies ,Young Adult ,03 medical and health sciences ,Liver disease ,Hepatitis B, Chronic ,0302 clinical medicine ,Immune system ,SDG 3 - Good Health and Well-being ,Antigen ,Virology ,medicine ,Humans ,Young adult ,Transaminases ,Aged ,Aged, 80 and over ,Hepatology ,business.industry ,Middle Aged ,Viral Load ,Hepatitis B ,medicine.disease ,Phenotype ,030104 developmental biology ,Infectious Diseases ,DNA, Viral ,Immunology ,Female ,030211 gastroenterology & hepatology ,business ,Viral load ,Biomarkers ,Cohort study - Abstract
The aim of this study was to assess the validity of categorization of chronic hepatitis B viral infection into stages or phases based upon measures of disease activity and viral load, assuming these phenotypes will be useful for prognostication and determining the need for antiviral therapy. We assessed the phenotype of hepatitis B of 1,390 adult participants enrolled in the Hepatitis B Research Network Cohort Study, using a computer algorithm. Only 4% were immune tolerant, while 35% had chronic hepatitis B (18% e antigen positive and 17% e antigen negative) while 23% were inactive carriers. Strikingly, 38% of participants did not fit clearly into any one of these groups and were considered indeterminant. The largest subset of indeterminants had elevated serum aminotransferases with low levels of HBV DNA (less than 10,000 iu/mL). Subsequent determination of hepatitis B phenotype on the next available laboratory tests showed that 64% remained indeterminant. These findings call into question the validity of conventional staging of hepatitis B, in large part because of the substantial proportion of patients who do not fit readily into one of the usual stages or phases. Further studies are needed of the indeterminant category of chronic hepatitis B viral infection, including assessments of whether patients in this group are perhaps in transition to another phase or if they are a distinct phenotype with a need to assess liver disease severity and need for antiviral therapy. (ClinicalTrials.gov identifier NCT01263587).
- Published
- 2016